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Old 10-06-2006, 10:06 PM   #1
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schizoaffective disorder vs. bipolar 1

Perhaps someone here can clarify this for me:

The difference between bp 1 and schizoaffective disorder, from what I have read (but the sources are not consistent) is that with schizoaffective disorder, a person can go through the cycles of depression and mania and have psychotic episodes when depressed or manic, but can also experience psychosis when stable.

Say someone has visual (paranoid) hallucinations "out of the blue," but feels fine when they are over, or hears music in his/her head or is delusional (grandiosity, paranoia, for example), all of these for perhaps a few hours/a day at most and very infrequently in a stable state with no other signs of mania or depression, would this constitute schizoaffective disorder? Or could the person be a rapid cycler even if there are no other symptoms of mania or depression whatsoever. But this person ALSO has episodes of mania with a number of symptoms (hypersexuality, spending, aggression, heightened energy, less sleep, etc.) PLUS the psychotic featured mentioned before (but much more frequently and in terms of delusion, consistently during the episode).

I hope this makes sense. I am just wondering if people with bp 1 sometimes experience psychosis during a stable phase or only when manic or depressed.

 
Old 10-07-2006, 10:53 AM   #2
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Re: schizoaffective disorder vs. bipolar 1

Hi Neleah,

what is schizoaffective? In the UK i only know (paranoid) schizophrenia.

i have a cousin who is PS. He is dellusional ALL the time without meds. His moods do fluctuate, but he is seemingly someone else most of the time. he has a voice all the time, but it's sort of religious and inherits his body. The only person who can ever speak to him and bring him down to earth is his mum. But she has NO life what so ever (except when he's institutionalised which is several times a year - he stops his meds). IMHO it is much more serious and debilitating.

Is there a PS board on here?

jgr

 
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Old 10-12-2006, 09:29 PM   #3
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Re: schizoaffective disorder vs. bipolar 1

Hi jgr01,

Yes, European diagnostic criteria are a bit different, right?
I am no expert, but from what I have read, schizoaffective disorder means that a person has primary symptoms of schizophrenia (delusions, hallucinations) along with times when s/he also has symptoms of depression and or mania (and then there are subtypes, either manic or depressive). So they have the symptoms of both bipolar and schizophrenia while schizophrenia "only" comes with the delusions, but not the mood disorder. And the difference between schizoaffective disorder and bipolar is that with schizoaffective disorder, the person is also delusional/has hallucinations, etc. when stable and not just when in a manic and/or depressive episode.

This is from what I have read, so don't quote me on it...

My friend's husband is schizophrenic, but he does not have mania. He does have major depression, too, though, so perhaps it's actually schizoaffective disorder...I don't know...It's pretty confusing...

There is a schizophrenia forum on here.

Last edited by Neleah; 10-12-2006 at 09:31 PM.

 
Old 10-13-2006, 03:57 AM   #4
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Re: schizoaffective disorder vs. bipolar 1

Yes, you nailed it right on the head. A schizoaffective has psychotic symptoms even when they're experiencing a normal mood; someone with bipolar I only has psychotic symptoms when manic. They may also have psychotic depression, but it's less common. However, once they've been stabilized, the hallucinations and delusions disappear.
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Old 10-13-2006, 11:33 AM   #5
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Re: schizoaffective disorder vs. bipolar 1

Quote:
Originally Posted by GatsbyLuvr1920
Yes, you nailed it right on the head. A schizoaffective has psychotic symptoms even when they're experiencing a normal mood; someone with bipolar I only has psychotic symptoms when manic. They may also have psychotic depression, but it's less common. However, once they've been stabilized, the hallucinations and delusions disappear.
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Ah, thanks! Do you know if the treatment for bipolar 1 and schizoaffective disorder is the same?

 
Old 10-14-2006, 06:30 AM   #6
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Re: schizoaffective disorder vs. bipolar 1

Well, schizoaffective disorder usually needs more medications to be treated, simply because it's like two serious psychiatric disorders combined into one. The logical treatment approach would be to have the person on both a mood stabilizer and an anti-psychotic. I suppose that the person could just be on an atypical anti-psychotic because they are being used more often now in the treatment of bipolar disorder, but I'd imagine that using both would be the first approach. Just like with regular bipolar disorder, the moods in schizoaffective disorder need to be played around with, when it comes to medication. For most, Lithium would be the best choice because the schizoaffective usualy would be psychotic during mania, making them have bipolar I symptomatology. However, Lithium doesn't always work. They may have to try the anti-epileptics, like Depakote or Tegretol or one of the other mood stabilizers like Lamictal, especially if they would only have bipolar II symptomatology and not become manic at all (and thus, not psychotic) and/or have psychotic depression. I actually have never heard whether a schizoaffective could have only hypomania and have the bipolar half of their condition be like bipolar II. Just like any other psychiatric disorder, it's really just trial-and-error to find what works best for the individual's brain chemistry.
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Last edited by GatsbyLuvr1920; 10-14-2006 at 06:33 AM.

 
Old 10-14-2006, 04:10 PM   #7
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Re: schizoaffective disorder vs. bipolar 1

Thank you so much, that helps tremendously! He is most certainly psychotic when manic (very delusional continuously and occasionally paranoid). His psychotic episodes when stable were mostly auditory and visual hallucinations (mostly paranoid and during the two visual hallucinations I witnessed, he was very scared). He was stable, then all of a sudden he would hallucinate and freak out and about an hour later (at most) it was over and he was back to normal. I always thought he was cycling, but there were no other symptoms of mania or depression (as opposed to other incidents were he was manic or depressed for about a day, but not necessarily psychotic).

Thank you for clarifying all this for me. It makes much better sense now!

 
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